How much does Medicare pay for CPT 11750?

Medicare allowed an average of $140.90 per service and paid $103.05 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $391.86, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11750?

Permanent removal fingernail or toenail. It was billed 100,085 times to 78,949 Medicare beneficiaries by 3,364 providers in 2024.

Does 11750 pay differently in an office than a hospital?

Yes. The allowed amount averaged $142.80 in an office setting and $83.08 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 11750 most?

Podiatry, with 98,863 services from 3,319 clinicians. Next are Nurse Practitioner, Ambulatory Surgical Center, Physician Assistant.

CPT 11750

Permanent removal fingernail or toenail

$140.90Medicare-allowed amount per service, averaged across 100,085 services

Providers submitted

$391.86

Asking price, not received

Medicare allowed

$140.90

The fee schedule figure

Medicare paid

$103.05

Balance is patient coinsurance

Providers submitted an average of $391.86 for this code and Medicare allowed $140.90 — 2.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $103.05 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $142.80
Hospital / facility: $83.08

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 96,894 services were billed in an office setting and 3,191 in a facility.

Services: 100,085
Beneficiaries: 78,949
Providers billing it: 3,364
Total allowed: $14,101,977

What Medicare pays for CPT 11750

Across 100,085 services billed by 3,364 providers to 78,949 beneficiaries, Medicare allowed an average of $140.90 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 11750

Specialty	Services	Beneficiaries	Avg allowed	Providers
Podiatry	98,863	77,985	$141.29	3,319
Nurse Practitioner	506	400	$113.32	23
Ambulatory Surgical Center	263	217	$68.65	4
Physician Assistant	167	128	$110.40	10
General Practice	74	60	$178.89	1
Internal Medicine	63	49	$149.58	1
Family Practice	48	26	$88.66	1
Orthopedic Surgery	41	32	$106.29	2
Unknown Supplier/Provider Specialty	29	22	$101.79	1
Pain Management	20	19	$149.68	1
General Surgery	11	11	$172.09	1

11750 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	9,812	$158.23	$107.64	287
Florida	8,354	$147.81	$110.29	279
Texas	8,156	$141.27	$107.20	294
Arizona	4,257	$140.98	$106.42	145
North Carolina	4,055	$138.29	$104.79	131
Tennessee	3,503	$131.86	$105.61	111
Georgia	3,302	$141.77	$110.39	112
Virginia	3,034	$147.30	$108.17	107
Illinois	2,881	$141.13	$106.26	122
Indiana	2,781	$133.33	$104.44	97
South Carolina	2,722	$132.72	$102.85	73
Maryland	2,659	$160.62	$113.49	88
Ohio	2,377	$135.20	$104.81	100
Missouri	2,334	$127.94	$98.66	76
New York	2,203	$163.32	$111.67	78
Michigan	2,169	$141.43	$107.94	96
Washington	2,156	$139.57	$98.59	79
Iowa	2,155	$130.62	$99.50	67
Oklahoma	2,044	$130.41	$105.16	57
Pennsylvania	2,026	$135.20	$101.51	89
Alabama	1,942	$121.96	$101.69	45
Arkansas	1,938	$128.13	$107.37	43
Colorado	1,815	$145.29	$105.21	62
Massachusetts	1,803	$157.64	$110.86	48
Kentucky	1,574	$130.90	$104.08	55
Louisiana	1,574	$128.94	$104.83	47
Kansas	1,563	$127.01	$101.67	39
Oregon	1,537	$141.66	$102.53	55
Wisconsin	1,427	$126.67	$94.36	58
Utah	1,221	$135.34	$102.54	49
Idaho	1,151	$127.20	$101.31	37
New Jersey	1,122	$163.16	$112.53	52
Nebraska	1,065	$117.99	$92.10	34
Minnesota	1,030	$129.42	$92.96	37
Nevada	811	$141.81	$105.98	26
New Mexico	787	$134.02	$103.64	28
Mississippi	743	$129.88	$108.32	16
Montana	573	$125.31	$93.61	19
South Dakota	563	$121.66	$88.72	14
North Dakota	481	$99.69	$73.10	17
Delaware	455	$150.88	$110.86	18
New Hampshire	342	$142.40	$104.41	13
Wyoming	270	$142.48	$101.36	7
Connecticut	244	$165.01	$106.73	11
Rhode Island	209	$148.13	$107.98	10
Alaska	172	$132.30	$78.82	7
Hawaii	162	$158.62	$112.53	7
West Virginia	136	$115.23	$85.26	5
District of Columbia	124	$180.44	$118.16	6
Maine	92	$133.26	$100.10	5
Vermont	90	$131.40	$95.47	3
Puerto Rico	59	$150.13	$103.91	2
XX	30	$156.82	$122.24	1

Related codes

11721Removal of fingernails or toenails$42.83
11720Removal of fingernails or toenails$31.70
11719Trimming of fingernails or toenails$10.40
11730Simple separation of fingernail or toenail from nail bed$108.98
11755Biopsy of fingernail or toenail$106.95
11765Removal of skin of fingernail or toenail$143.69
11732Simple separation of fingernail or toenail from nail bed$32.18
11740Removal of blood accumulation under fingernail or toenail$40.74
11760Repair of fingernail or toenail bed$122.75

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.